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Our Lady of Mount Carmel Student Registration 2019-2020
Please register each child individually.
If the question does not apply to you please type "None or N/A" in the box.
Students Last Name *
Your answer
Student First Name *
Your answer
Date of Birth *
Your answer
Primary Email Address *
Main communication for all PSR updates.
Your answer
Primary Home Phone Number *
Your answer
Primary Cell Phone Number *
Your answer
Student's Primary Address *
Your answer
New or returning student? *
What class will this student participate in? *
School Attending *
What school does this student go to?
Your answer
Student resides with *
Who does this student live with?
Mother's Name *
Your answer
Mother's Phone Number *
If different from primary phone numbers
Your answer
Mother's Address *
If different from student's primary address.
Your answer
Mother's Email Address *
If different from primary email address
Your answer
Mother's Religion *
Your answer
Mother's Occupation *
Your answer
Father's Name *
Your answer
Father's Phone Number *
If different from primary numbers
Your answer
Father's Address *
If different than student's primary address.
Your answer
Father's Email Address *
If different from primary email address
Your answer
Father's Religion *
Your answer
Father's Occupation *
Your answer
Other Emergency Contact Name *
In the event of an emergency, whom should we contact other than yourself?
Your answer
Other Emergency Contact Phone Number *
Please Type Phone Number
Your answer
Sacraments *
Check each sacrament that this student has completed.
Required
Sacramental Preparation
If applicable, check if this student is participating in a sacramental preparation class this year.
If this student has any allergies, medical conditions or special needs of which we should be aware of, please list and explain. *
Your answer
Affirmation of Parent/Guardian Responsibilities *
As the primary instructor of your child's Catholic education and formation, you are committed to full and active participation in your child's faith development and promise to promote Catholic Church teachings and Christian values. Please check each box showing your acknowledgement of the following:
Required
Name of person completing this form. *
Include full name.
Your answer
Date Completed *
Your answer
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